Should the Supreme Court strike down President Obama health care reform, is the health care industry in for chaos? Tom Pennington/Getty Images

March 23, 2012

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Next week, the Supreme Court will begin hearing three days of arguments over the constitutionality of President Obama's sweeping overhaul of the health care system. It is a massive piece of legislation, with numerous moving parts, that will have a significant impact on American society if it's allowed to stand. Similarly, its defeat would trigger a wave of important repercussions — not only on health care, but on Congress and the November presidential election. Here, five possible ramifications if the court rejects the controversial reform law:

1. Health care reform could go back to the drawing board If the court strikes down the entire law, it will kill a broad new entitlement "before it has a chance to take root" and fulfill its goal of bringing coverage to 30 million people who are currently uninsured, say Mark Sherman and Ricardo Alonso Zaldivar at Insurance Journal. Parts of the law that are already in effect — such as one that allows young adults under the age of 26 to remain on their parents' coverage — would have to be "rolled back." To address rising health care costs and to cover the uninsured, Congress will have to "roll the ball up the hill again."

2. Without the individual mandate, the system might collapseThe individual mandate — which requires most Americans to purchase insurance — is the most contentious aspect of "ObamaCare." The court might void only that element and leave the rest of the reform package intact. But without everyone in the country forced to find coverage, the system could fail. Healthy people may avoid buying insurance until they're sick, depriving the system of the revenue it needs to cover those with expensive or debilitating illnesses. If the mandate goes, Congress can replace it by imposing a "new tax" on those who opt out of health insurance, or by passing incentives to encourage young, healthy people to enroll, says David Morgan at Reuters. That's unlikely, however, because it would require bipartisan support "during an election year when Republicans are already moving to repeal" the law.

3. The health care industry could lose a ton of moneyInsurance companies and hospital chains stand to benefit from the legislation, since it will offer them 30 million new customers. If the individual mandate were repealed, you'd see shares of those companies "drop steeply" because they would stand to lose all those customers, says Lewis Krauskopf at Reuters.

4. Congress' authority may be curbedStriking down the law would be a "grave step" in reorganizing the balance of power between Congress and the Supreme Court, Neal Katyal, a former acting U.S. solicitor general, tells The Huffington Post. The court would essentially remove Congress from "the national discourse" on how to solve the problems of health care. Instead, the court should let the democratic process work: "Look if you don't like ObamaCare, there's a very easy solution, which is to vote the president out of office."

5. Republicans would proclaim a political victory The court's decision "will be of immense importance to Americans and a president seeking re-election in November," says Dan Robinson at Voice of America. If the law is struck down, "opponents will claim victory and argue" that Obama "mishandled his signature legislative achievement." It will also focus the conversation on the health care law, which is still politically unpopular — and Obama doesn't want that either.